SPACE, Parent-Based Treatment for Childhood and Adolescent Anxiety: Clinical Case Illustration

2020 ◽  
Vol 34 (2) ◽  
pp. 107-118 ◽  
Author(s):  
Eli R. Lebowitz ◽  
Jennifer M. Majdick
Keyword(s):  
Recent Literature ◽  
Parental Behavior ◽  
Behavioral Therapy ◽  
Child Anxiety ◽  
Childhood Anxiety ◽  
Treatment Modalities ◽  
Childhood Anxiety Disorders ◽  
Adolescent Anxiety ◽  
Supportive Parenting ◽  
Efficacious Treatment

Efficacious treatments for childhood anxiety disorders include Cognitive Behavioral Therapy (CBT) and medications, yet there is urgent need for additional efficacious treatment modalities. Parent-based treatment provides such an alternative. Recent literature has supported that SPACE (Supportive Parenting for Anxious Childhood Emotions), an entirely parent-based treatment, is as efficacious as CBT in reducing child anxiety. SPACE focuses on systematically reducing family accommodation, or changes to parental behavior aimed at alleviating or avoiding a child's distress related to their anxiety disorder, while maintaining a supportive stance toward the child. To date, SPACE is the only intervention that places the reduction of parental accommodation at the center of its theoretical foundation and treatment objectives. This article provides theoretical and empirical background for SPACE and illustrates its implementation through a case description.

scholarly journals Using a Smartphone App and Clinician Portal to Enhance Brief Cognitive Behavioral Therapy for Childhood Anxiety Disorders

2019 ◽  
Author(s):  
Jennifer Susan Silk ◽  
Gede Pramana ◽  
Stefanie Sequeira ◽  
Oliver Lindhiem ◽  
Philip C. Kendall ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Cognitive Behavioral Therapy ◽  
Anxiety Disorders ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Child Anxiety ◽  
Childhood Anxiety ◽  
Post Treatment ◽  
Cognitive Behavioral ◽  
Childhood Anxiety Disorders

Cognitive behavioral therapy (CBT) is an efficacious treatment for child anxiety disorders, but 40-50% of youth do not respond fully to treatment, and time commitments for standard CBT can be prohibitive for some families and lead to long waiting lists for trained CBT therapists in the community. SmartCAT 2.0 is an adjunctive mobile health program designed to improve and shorten CBT treatment for anxiety disorders in youth by providing them with the opportunity to practice CBT skills outside of session using an interactive and gamified interface. It consists of an app and an integrated clinician portal connected to the app for secure 2-way communication with the therapist. The goal of the present study was to evaluate SmartCAT 2.0 in an open trial to establish usability, feasibility, acceptability, and preliminary efficacy of brief (8 sessions) CBT combined with SmartCAT. We also explored changes in CBT skills targeted by the app. Participants were 34 youth (ages 9-14) who met DSM-5 criteria for generalized, separation, and/or social anxiety disorder. Results demonstrated strong feasibility and usability of the app/portal and high satisfaction with the intervention. Youth used the app an average of 12 times between each therapy session (M = 5.8 mins per day). At post-treatment, 67% of youth no longer met diagnostic criteria for an anxiety disorder, with this percentage increasing to 86% at two-month follow-up. Youth showed reduced symptom severity over time across raters and also improved from pre- to post-treatment in CBT skills targeted by the app, demonstrating better emotion identification and thought challenging and reductions in avoidance. Findings support the feasibility of combining brief CBT with SmartCAT. Although not a controlled trial, when benchmarked against the literature, the current findings suggest that SmartCAT may enhance the utility of brief CBT for childhood anxiety disorders. This paper is currently in press in Behavior Therapy.

Is Your Child’s Anxiety Taking Over Your Family?

2020 ◽  
pp. 43-50
Author(s):  
Eli R. Lebowitz
Keyword(s):  
Behavioral Problems ◽  
Parental Behavior ◽  
Child Anxiety ◽  
Childhood Anxiety ◽  
Family Context ◽  
Emotional And Behavioral Problems ◽  
Childhood Disorders ◽  
Psychological Theories ◽  
Natural Tendency ◽  
The Family

This chapter addresses child anxiety in the family context, starting with the myth that parents cause anxiety problems in their children. The idea that parents are responsible for children’s emotional and behavioral problems stems in large part from inaccurate assumptions about human development; outdated psychological theories; misunderstandings of research on the links between parental behavior and childhood disorders; and an incorrect interpretation of family dynamics. On the other hand, a child’s anxiety problem is likely to have an impact on the parents and on the rest of the family. The reason that childhood anxiety, more than other problems, can have such a large impact on parents is that when a child is feeling anxious, they look to their parents to help them feel better. But why are anxious children so reliant on parents? The reason has to do with the very nature of anxiety in humans. The natural tendency of the child to look to the parents for protection and reassurance when feeling worried, scared, or stressed is essentially hardwired into the human brain.

scholarly journals Using a Smartphone App and Clinician Portal to Enhance Brief Cognitive Behavioral Therapy for Childhood Anxiety Disorders

2020 ◽  
Vol 51 (1) ◽  
pp. 69-84 ◽  
Author(s):  
Jennifer S. Silk ◽  
Gede Pramana ◽  
Stefanie L. Sequeira ◽  
Oliver Lindhiem ◽  
Philip C. Kendall ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Anxiety Disorders ◽  
Behavioral Therapy ◽  
Childhood Anxiety ◽  
Cognitive Behavioral ◽  
Smartphone App ◽  
Childhood Anxiety Disorders

scholarly journals The Relation of Severity and Comorbidity to Treatment Outcome with Cognitive Behavioral Therapy for Childhood Anxiety Disorders

2010 ◽  
Vol 38 (5) ◽  
pp. 683-694 ◽  
Author(s):  
Juliette Margo Liber ◽  
Brigit M. van Widenfelt ◽  
Adelinde J. M. van der Leeden ◽  
Arnold W. Goedhart ◽  
Elisabeth M. W. J. Utens ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Cognitive Behavioral Therapy ◽  
Anxiety Disorders ◽  
Behavioral Therapy ◽  
Childhood Anxiety ◽  
Cognitive Behavioral ◽  
Childhood Anxiety Disorders

Child Anxiety

2020 ◽  
pp. 27-42
Author(s):  
Eli R. Lebowitz
Keyword(s):  
Mental Health Problems ◽  
Separation Anxiety ◽  
Behavioral Therapy ◽  
Child Anxiety ◽  
Childhood And Adolescence ◽  
Obsessive Compulsive ◽  
Adolescent Anxiety ◽  
Healthy Habits ◽  
Illness Anxiety ◽  
Fear And Anxiety

This chapter discusses the main types of childhood and adolescent anxiety. There is no limit to the variety of things that can cause a child anxiety, but some fears and worries are more common than others. The most commonly diagnosed anxiety disorders include separation anxiety; social anxiety (also called social phobia); generalized anxiety; phobias; panic disorder; agoraphobia; obsessive-compulsive disorder (OCD); illness anxiety; and avoidant/restrictive food intake disorder, which is not an anxiety disorder per se, but is commonly associated with fear and anxiety. Of all the emotional and mental health problems that occur during childhood and adolescence, anxiety is the most treatable. Treatments for childhood and adolescent anxiety include cognitive behavioral therapy (CBT) and medication for anxiety. Healthy habits can also help to keep anxiety under control.

Planning How Parents Will Reduce Accommodation

2019 ◽  
pp. 81-92
Author(s):  
Eli R. Lebowitz
Keyword(s):  
Parental Behavior ◽  
Child Anxiety ◽  
Childhood Anxiety ◽  
Anxiety Symptoms ◽  
Parental Attitude ◽  
Family Accommodation ◽  
The Common

Effectively helping parents to reduce family accommodation of childhood anxiety requires careful and thoughtful planning. This chapter provides guidance on formulating effective and realistic plans for changes in parental behavior aimed at reducing family accommodation of child anxiety symptoms. A well-crafted plan will be focused, specific, and pragmatic. It will also avoid the common pitfalls that can hinder implementation, which are discussed in the next chapter. This chapter also provides guidelines and examples for communicating the plan to the child and maintaining a supportive parental attitude. Clinical anecdotes and sample texts enrich the chapter and bring the content to life.

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